Sow Birth Control and Reap Abortion

Anthony Zimmerman
Reign of the Sacred Heart
December 1966
Reproduced with Permission

Two eminent Catholic priests have written optimistically about Government action in the field of birth control (Pastoral Life, July-Aug., 1966). Their optimism would wilt, I believe, if they had more experience with the ugly reality of government programs now operating outside the United States.

Father John A. O'Brien indicates great confidence that peoples of developing areas will practice birth control successfully if they are only provided with needed information. "Give the people light enough and public opinion will not only reflect the facts when properly explained, but also demand action in accordance with them." (I presume he means public opinion as possessed by enlightened citizens, not the end product of a brain washing process which obtains superficial compliance with the will of manipulators of mass media, and is a species of coercion.)

Fr. Dexter L. Hanley, S.J., quotes with approval a statement which similarly supposes that a government can obtain a reduction in birth rates by opening clinics in which people can freely obtain information about methods of birth control which agree with their consciences. We truly wonder whether he is aware of how far beyond this point governments have already gone in their efforts to reduce birth rates. Mere clinics would get them nowhere. As Mr. R.P. Goyal told us at the Second World Population Conference (Belgrade, 1965), attendance at Indian Family Planning Clinics is minimal, averaging about 6 persons per month. To reduce birth rates, governments are using psychological dynamite and bulldozers, not stories about bees and flowers.

Both writers gave a kind of left-handed approval to government action which is at once effective in lowering birth rates, but which does so without coercing the people. The facts which are here detailed will indicate, I believe, that their expectations are not realistic.


It is significant that Japan's notorious abortion problem arose against the express wish of the government, and despite specific efforts to prevent just such a thing. The intention of the birth control movement, which became semi-official with passage of the Eugenic Protection Law in 1948, was to lower national birth rates by popularizing contraception and rhythm. Abortions, nevertheless, spread like an epidemic, their number rising from about 50,000 per year to 2,000,000 within the space of five years. Today, 18 years later, there are 6,000 per day as thriving gynecologists perform operation after operation on mothers who give fatalistic consent. Recently the number has begun to decline slightly, at least if we can trust official statistics. Some claim the people are finally becoming more skilled in the use of contraceptives; others say the figures are unreliable, or that sterilization induced by abortion and by operations are reducing abortions bit by bit.

On November 8, 1961, South Korea adopted a policy of popularizing conception control to reduce the national population growth rate. One year later several leaders of family planning in Japan visited Korea and warned against the danger of abortion. Japan had adopted the policy of giving guidance in conception control, they explained, "to get rid of the horrible effect which induced abortion has on mothers in body and mind." Korea should take precautions from the outset: "It is felt keenly that the Government of the Republic of Korea ought to take measures to prevent the cases of induced abortion from increasing in number," stated the group after noting with concern that abortions were already on the increase. ("Summary Report of Inspection of the Family Planning Movement in the Republic of Korea" by Tachi, Kubo, Muramatsu.)


When I visited Korea in the summer of 1964, the family planning program was well on its way, matching Japan's performance of a decade and a half earlier: newspapers and magazines featured it almost daily, radio announcers wove propaganda into the newscasts, school teachers distributed take-home pamphlets, posters lighted street corners, movies spelled out details. Public Health Centers opened special departments, manned by trained personnel, to give mass instructions and individual guidance; student nurses were paid during the summer to do field work, spreading the message from house to house. I asked the director of a large health center whether he didn't believe that abortions were increasing as a result, and that abortions would account for the major part of any success in family planning as it does in Japan. He lowered his eyes, and answered softly, "It is true; it is inevitable. But it is part of my job now." Another public health official said he is opposed to full liberalization of abortion laws as proposed by a bill then before the National Diet; however, he hoped for some liberalization, because abortions were increasing rapidly, and he wanted a legal method of studying their effects. And another Korean official told us at the Second World Population Conference that a nation which launches a birth control campaign owes it to the citizens to liberalize abortion laws to a certain extent. There will be many unwanted pregnancies, he explained, and the people should have a method of meeting this problem.

At a pilot project around Kimpo, in which the Lippes Loop Intra-Uterine Device (IUD) was featured, there were 6.4 abortions per 100 births at the beginning of the project, 17.2 a year later, and 23.9 at last count. And at Wondang the total number of abortions during a two year pilot project to popularize contraception was higher than the total during the entire lives of the women up to that time. In Seoul, among 3,204 women, there is a total reproductive history of 14.7 abortions per 100 live births. In 1961 this was 21.1; in 1962, 37.6; and in 1963, 49.0. Despite precautions, therefore, Korea appears to be well on its way to rival Japan as an "abortion paradise," as Japanese newspapers put it.

Dr. Bernard Berleson, Vice President of the Population Council in New York, America's leading non- governmental birth control promotion center, reported as follows concerning family planning and abortion: "Valid scientific surveys from four different countries have shown that increasing motivation for family planning brings in its wake an increasing incidence of induced abortion." (Cited at World Population Conference.)

Dr. Ronald Freedman stated at the World Population Conference that an increase of abortion is apparently an important factor in the initial stages of a decline in birth rates, and that it is probably safe to say that abortion is the most used method of birth control in the world today.

One estimate of the number of abortions committed annually in the world today runs as high as 30,000,000. Our knowledge about its prevalence is fragmentary, of course, but I know of no better estimate.


Many have hoped that the IUD would put an end to worries about abortion. The following data, however, give little reason for optimism.

At the Second Regional Seminar of the International Planned Parenthood Federation (Tokyo, May 25-6, 1966), Dr. Chen reported that there were 178,000 acceptors of the IUD in Taiwan at the end of March. A random sampling interview, covering 2,181 cases throughout Taiwan, indicated that there were 8 pregnancies per 100 women years of users, and that 78% of them were terminated in abortion. The survey also revealed that the majority of the women had stopped using the IUD after a year and a half: 31.4% stopped after 6 months, 49.7% after a year, and 64% after 18 months. Dr. Chen reported: "If the Province-wide interview reflects an accurate picture of the large scale IUD program, almost one-third of the loops inserted are gone after 6 months, half of them after one year, and two-thirds of them are discontinued for use after a year and a half." The pregnancy rate of the discontinued users was much higher than anticipated, 55.3 per 100 woman years. "Since most of these pregnancies, however, will probably end in induced abortion, the actual fertility rate of these women might not be high even after the use of the IUD is discontinued," he observed.

Professor Chun of Hong Kong reported at the same Seminar that the pregnancy rate of women with the IUD device in place was 2.7 %. He continued: "Accidental pregnancy is a real disadvantage in the use of this method. Patients are often very upset or even hysterical when told that they are pregnant. Dr. Guttmacher (USA) recommends induced abortion for such patients who get pregnant, but this is prohibited in Hong Kong. ... The abortion rate was very high in this group of 472 pregnant patients, that is, 30%."

Dr. Yoshio Koya, President of the Family Planning Federation of Japan, believes that increased motivation to prevent births, followed by unplanned pregnancy, is the causal link to the observed increase of abortion: "Had there been few people seeking to check childbirths, the practice of induced abortion would not have grown as it did" [in Japan]. (Pioneering in Family Planning, p. 23.) Later in the same booklet he states the case more forcefully: "From the increase in induced abortions . . . it would seem that women preferred induced abortion to the alternative of bringing an unwanted child into the world. Can we blame them for that? Absolutely not, because this line of reasoning reflects the results of our educational activity." (P. 84.) He refers to the educational activity of the Planned Parenthood Federation. Much propaganda favoring family planning has made pregnancies, after one or two children are born, unwelcome. But pregnancies occur with disconcerting regularity, despite precautions. Hence the many abortions.


Dr. Kaseki, leading gynecologist in Nagoya, has advised colleagues that they may indeed continue to give guidance against conception, but they should encourage women to bear their children if they conceive. As an experiment he tried to persuade 20 patients, who had presented themselves for abortion, to bear the child and have it adopted. To the last woman, all refused steadfastly. Bearing a child seemed to them a major defeat. The neighbors would gossip. As villagers in one case were overheard to say: "Just look at that house over there; those people are having one baby after another despite being so poor. And the authorities told us so exactly not to do that. What kind of people do they think they are?" Public opinion has become a tyrant, exerting coercion for all practical purposes.

Mothers of more than three children tend to shy away from PTA meetings from a sense of shame, even at our Catholic kindergartens. Sometimes they are advised by other women: "Don't you realize that your children are being ridiculed in school for coming from a too large family? How can you be so inconsiderate?"

An unplanned, unwanted, accidental pregnancy, after tedious efforts to avoid it, appears to be such a psychological burden that it drives women to the abortionist with an almost irresistible compulsion. As Dr. Koya stated to delegates at the All Japan Family Planning Conference in 1958: ". . . When women who are motivated to limit birth become pregnant accidentally, they cannot be dissuaded from resorting to induced abortion. The only alternative to induced abortion, therefore, is education in successful contraceptive practice. To prohibit abortion by law would be not to abolish the practice but to drive it into the black market, with all its attendant evils." By reading between the lines, one discovers here that education in family planning, the way it has been done in Japan, induces a mentality which does not hesitate to resort to abortion should contraception fail. Even though contraceptive techniques be improved in the future, the mentality of people brain-washed by family planning propaganda, with the backing of a government, will probably be on the same depressed level.


Fathers O'Brien and Hanley, needless to say, reject abortion. Fr. Hanley also states that there must be no coercion, direct or indirect, to reduce the number of births. He writes about setting up family-planning clinics which would instruct citizens in the technique of rhythm in South American countries. I have no experience in South America, so will not pass judgment on the last proposal. In the half of the world where I am working, however, I think such rhythm clinics would be a service to a certain percentage of people, and I favor their establishment. However, they would make hardly any difference in national birth rates. The reasons for this seem to escape the two writers.

The reasons why clinics to which people have free access are not sufficient in themselves to reduce national birth rates was explained to us very well at the 1963 Asian Population Conference at New Delhi, by Mr. R.A. Gopalaswami in the paper "Planned Development and Population Growth." I quote at length:

Contraception (by definition) entails the taking of precautions which constitute an unnatural and irksome interference with the spontaneity of conjugal relations. To take such precautions all the time, month after month, and year after year for decades would be felt to be a perpetual nuisance unless one's mind has become conditioned to the practice. Such conditioning seems to occur only in those cases where, for health reasons or social and economic reasons, there is extreme anxiety to avoid another conception. For good or ill, such anxiety does not arise until a certain level of education, income and consequent standard of living is attained. The concern for preservation of that level is not strong enough when the level is low. Even in the absence of such concern, people readily acknowledge that they would be better off with smaller families. But they do not go further because they seem to feel that the continuing nuisance of contraception is too high a price to pay.

A certain minimum level of both education and income seems to be a pre-requisite for serious acceptance and regular use of contraceptive appliances as well as the practice of non-appliance methods of contraception. At least three out of four agricultural families and two out of three nonagricultural families in the country must be reckoned as falling below this "income-education bracket" and consequently beyond the reach of conventional methods of contraception. The reasons are not far to seek. These large classes of people are, for one thing, too poor. The mere thought of the purchase of appliances becoming a regular addition to the meager budget of household expenditure acts as a deterrent. Then the housing conditions are too primitive. There is no privacy. It is difficult to store the appliances where the children would not get at them. Facilities needed for hygienic use of appliances is absent.

"The difficulties are serious. If they are to be overcome the mind must be conditioned to a very strong determination to avoid further childbirth. But here is the greatest difficulty. Such a determination can be evoked, but only spasmodically. Sustained determination is present only among a minority of the "educated non-poor;" and there too afterthey have acquired a large family.


Mr. Gopalaswami went on to prove his case by stating that in Japan, where people know all about contraceptive appliances, and there they have attained a relatively high level of education and income, and the living standard is quite advanced, the majority of the success of birth control must be attributed to abortion: "Clearly, because they preferred the occasional and contingent discomfort involved in induced abortion to the continuing nuisance of contraception." He attributes the mass upsurge of abortion in Hungary, Bulgaria, Czechoslovakia and Poland to the same cause. He realizes that contraception will spread among millions in India, "but it is not the answer to the problem of implementing a national child-birth ceiling and achieving the needed reduction of the national birth rate in time." He recommended mass sterilization at the time: first covering those who already have their 2 or 3 children, then on a permanent basis at the rate of about 2.5 to 3 million sterilizations per year. There should be no statutory compulsion towards this, "but there is need for mobilizing public opinion in such a manner as to operate as moral compulsion. An alert public opinion should be created so that any family in which a child birth of the fourth or higher order occurs will feel that it has lost social status in consequence."

In the meantime it is becoming clear that sterilization has relatively little support. Mr. R.P. Goyal reported at the World Population Conference that "surveys carried out to find out the attitude of the people towards sterilization as a family planning method show that this measure has little support." Since attendance at family planning clinics is minimal, and the number of persons currently using contraceptives in India is not even 1%, the prognosis in this area is not favorable. Another survey indicated that abortion is considered by few Indians as a fitting means of population control. "A majority of them thought it was against religion and would affect the health of the mothers adversely."


What then is to be done? I believe that the two priests have steered themselves into the treacherous straits with the Scylla of abortion on one side, and the Charybdis of no solution to overpopulation on the other, and have failed to see that there is a way out by going straight ahead. A majority of the delegates from 22 nations at the Asian Population Conference in New Delhi felt that birth control would be of little value in the immediate future for the development of the nations; they felt that social and economic development must precede widespread family planning, and that education could make an asset of the younger population rather than a deficit. They believe that a lowering of the birth rate is bound to come thereafter, when countries have reached a certain level of development. One of the delegates suggested that a raising of the marriage age could be an important factor of lowering the birth rate in the meantime; if the age for women in India were raised to a minimum of 19 years, and no child were born before the mother is 20, the birth rate would decline from 40 per 1000 population to 24 within 15 to 20 years, he calculated. And we know that a higher marriage age would be conducive to an improvement of family life, not only in India but also in America. Furthermore, for various reasons, economic development would tend to be accelerated by a raising of the median marriage age.

When a government diverts resources into a large-scale birth control program, and aims directly at reducing national birth rates, the people easily misunderstand about the means to be used to achieve the end in view. In fact, the government appears in their eyes to give at least tacit approval to every means, provided it is effective. Official laws and policies are a powerful influence in forming or de-forming consciences.

At bi-monthly meetings of the Japan Catholic Population Research Association, one hears again and again that the root of Japan's family problems is the government promotion of family planning. Several times high ranking government officials have blamed America for introducing this policy into Japan. The Association has put out a booklet on family life with recommendations, including this one that the government should ease itself out of the business of promoting family planning:

Since the promotion of birth control for the sake of national economic development violates natural principles, and is the deepest cause of Japan's present family troubles; and since promotion of this policy by a Government agency creates misunderstandings and exerts harmful pressures on the population ... be it resolved that the Ministry of Welfare disassociate itself from the national population control policy completely.


It is noteworthy that persons of influence in the government have pondered this recommendation with sympathy. One of them succeeded in cutting off a source of government funds for family planning, only to be frustrated when another source was made available. Another has printed a pamphlet to this effect, and is circulating it among his colleagues of the government ruling party.

If the American government imitates the Japanese government by promoting birth control at home and abroad; if it also sets up Dachau-like clinics to dispose of millions of fetuses and dulls the idealism of family life, perhaps it will also imitate Japan twenty years later by bowing itself out of this unworthy business. A wiser America would study Japan's experience today and decide not to blunder into the same simplistic trap.